Stages of Anaesthesia

Question 1

How many stages of Anaesthesia are there?

Answer 1

4

Question 2

Name the 4 stages of Anaesthesia

Answer 2

1. Voluntary excitement
2. Involuntary excitement
3. Deep anaesthesia (3x planes)
4. Overdose

Question 3

How many planes are there in Deep Anaesthesia?

Answer 3

3

Question 4

What defines Stage 1/Voluntary excitement stage?

Answer 4

From Induction > loss of consciousness

Question 5

What defines Stage 2/InVoluntary excitement stage?

Answer 5

Unconsciousness > Rhythmic breathing

Question 6

What defines Stage 3/Plane 1?

Answer 6

The suitable depth for MINOR surgery
Such as:
1. Wound suturing
1. Removal of small masses

Question 7

What defines Stage 3/Plane 2?

Answer 7

Adequate depth for most procedures

Question 8

What defines Stage 3/Plane 3?

Answer 8

Other known as DEEP anaesthesia

Question 9

What defines Stage 4?

Answer 9

OVERDOSE

Question 10

8 …

Identify the signs you should observe Stage 1, Voluntary Excitement plane of anaesthesia

Answer 10

1. Inc pulse
2. Inc RR
3. Dilated pupils
4. Inc Skeletal muscle tone
5. Vocalisation
6. Salivation
7. Urination
8. Defecation

Question 11

6 ….

Identify the signs you should observe Stage 2, INvoluntary Excitement plane of anaesthesia

Answer 11

1. Cranial nerve reflexes present
2. Eye - wide open
3. Pupils dilated
4. Ventromedial eye roll
5. Brisk withdrawl reflexes
6. Irregular breathing > becoming regular

Question 12

9 …

Identify the signs you should observe Stage 3, of the Deep, Plane 1 plane of anaesthesia

Answer 12

1. Regular + deep breathing
2. Absent limb movement
3. Brisk pinch reflex
4. Nystagmus (Slows then stops by end of plane 1)
5. Ventromedial eye
6. Partially across 3rd eyelid
7. Slower Palpebral reflex
8. Brisk Corneal reflex
9. Slight CV depression

Question 13

8 ..

Identify the signs you should observe Stage 3, Plane 2 plane of anaesthesia

Answer 13

1. Ventromedial eye
2. Sluggish > stop of Palpebral reflex
3. Persisting Corneal reflex
4. Constricted Pupils
5. Relaxed muscles
6. Sluggish > lost Pedal reflex
7. Reduced Tidal Volume (TV)
8. Slightly reduced HR + RR

Question 14

7 ..

Identify the signs you should observe Stage 3, Plane 3 plane of anaesthesia

Answer 14

1. Central eye
2. Open eyelids
3. Inc size pupil
4. Red RR
5. Red TV
6. Pedal reflex lost
7. Red HR + BP

Question 15

9 ..

Identify the signs you should observe Stage 4, Overdose plane of anaesthesia

Answer 15

1. Progressive Respiratory failure w/only diaphragmatic function
2. Very tacy or brady pulse
3. Central eye
4. Open eyelids
5. Dilated pupil
6. Dry cornea
7. Absent Corneal reflex
8. Cyanotic > grey MMs
9. Inc CRT

Question 16

What stage of anaesthesia is this?

Answer 16

• Stage 1
• Voluntary Excitment

Question 17

What stage of anaesthesia is this?

Answer 17

1. Stage 2
2. INvoluntary excitement

Question 18

What stage of anaesthesia is this?

Answer 18

1. Stage 3
2. DEEP anaesthesia
3. Plane 1

Question 19

What stage of anaesthesia is this?

Answer 19

1. Stage 3
2. Plane 2

Question 20

What stage of anaesthesia is this?

Answer 20

1. Stage 3
2. Plane 3

Question 21

What stage of anaesthesia is this?

Answer 21

1. Stage 4
2. OVERDOSE

Question 22

What stage of anaesthesia is most appropriate for most procedures?

Answer 22

Stage 3, Plane 2

Question 23

What stage of anaesthesia is most appropriate for Minor surgery, such as wound suturing + removal of small masses?

Answer 23

Stage 3, plane 1

Question 24

What are the 3 general stages of anaesthesia?

Answer 24

1. Light
2. Surgical
3. Overdose

Question 25

# 8 ... State the **physiological parameters** + **cranial reflexes** you should find in a **LIGHT** plane of anaesthesia.

Answer 25

1. Inc HR, PR + RR 2. **May breath hold** 3. Inc BP 4. **Dilated** pupil 5. **Central** eye 6. ***Brisk*** **palpebral** + **pedal** 7. ***Slight*** **jaw** tone 8. ***Good*** **Muscle** tone

Question 26

# 5 ... State the **physiological parameters** + **cranial reflexes** you should find in a **SURGICAL** plane of anaesthesia.

Answer 26

1. ***Slightly*** **reduced** + **regular** **HR**, **RR** + **BP**, but become more signifcant (red) as ana deepens 2. **Constricted** pupils 3. **Ventromedial** eye **roll** 4. ***Absent*** **Palpebral + Jaw** tone 5. ***Sluggish***/absent **Pedal**

Question 27

# 8 ... State the **physiological parameters** + **cranial reflexes** you should find in a **OVERDOSE** plane of anaesthesia.

Answer 27

1. ***Significantly*** **depressed** **CV** + **Resp** function 2. Dec **PR** + **BP** 3. **Failure** of **respiratory muscle** function 4. **Cyanosis** of MMs 5. ***Inc*** **CRT** 6. **Dilated** pupils 7. **Central** eye 8. ***Absent*** Palpebral, Corneal, Pedal + Jaw tone

Question 28

What 2 areas do you need to consider when monitoring anaesthesia?

Answer 28

1. **Physiological status** * Assess by observation * Measuring physiological parameters 2. **Level** of **consciousness** * Assess cranial nerve reflexes + responses * Which indicates the depth of anaesthesia

Question 29

Why is the **Corneal** reflex not a good indicator of the depth of anaesthesia?

Answer 29

* Because it is more related to **brainstem activity** * Which can **maintain intact** even after **cardiac arrest**! * It can also be absent even in a light or deeper plane of ana

Question 30

True or False. Jaw tone is progressively lost as anaesthesia deepens.

Answer 30

True

Question 31

True or False. The Palpebral reflex becomes progressively sluggish as anaesthesia deepens, but return in a surgical plane.

Answer 31

False. True or False. The Palpebral reflex **does** become **progressively sluggish** as anaesthesia **deepens**, but is **lost** in a **surgical** plane.

Question 32

True or False. The eye position becomes **rolls ventromedially** in a **surgical** plane of anaesthesia, but returns **centrally** as anaesthesia **deepens**.

Answer 32

True!